MISSION

Formed in 1962, the Group aims to challenge, re-define and develop standards of care in all controversial areas of breast cancer diagnosis and therapy, including rare conditions such as male breast cancer. The Group researches long-term outcomes and follows all patients throughout their lives.

PRACTICE CHANGING RESEARCH

Understanding Breast Cancer: A global challenge

Breast cancer is the most diagnosed and common cause of cancer deaths in women worldwide (one in six cancer deaths)[a]. In 2020 alone, 2.3 million women were diagnosed. While incidence rates vary globally, approximately one in every eight women in developed countries face a diagnosis in their lifetime[b].

Defining early-stage breast cancer

Early-stage breast cancer is defined as being confined to the breast (up to 5cm) and/or regional lymph nodes without distant metastases. With treatment, women with early breast cancer have a very good prognosis. Primary treatment is surgery, and additional therapies like chemotherapy or radiotherapy aim to reduce recurrence risk and improve survival while minimising toxicities for a better quality of life.

EORTC Breast Cancer Group Clinical Trials: advancing patient quality of life

The three EORTC Breast Cancer Group’s clinical trials that follow are examples of reducing treatment (without compromising patients’ survival rates) while having a significant increase in their quality of life.

[a] International Agency for Research on Cancer. Latest global cancer data: Cancer burden rises to 19.3 million new cases and 10.0 million cancer deaths in 2020. Press release 292. 15 December 2020. 

[b] https://www.who.int/news-room/fact-sheets/detail/breast-cancer 

Redefining early breast cancer treatment

Studies over the years have shown that treating women diagnosed with early breast cancer with chemotherapy after surgery (adjuvant chemotherapy) has a significant effect on their overall survival. Chemotherapy, however, can negatively affect patients’ overall health and quality of life in the long term. The MINDACT study sought to investigate whether women diagnosed with early breast cancer that had not spread beyond the breast and/or the nearby lymph nodes (the masses of tissue that help the body to fight disease), could be spared chemotherapy treatment after surgery without affecting their overall survival rate.

MammaPrint® test: a breakthrough in personalised early breast cancer treatment

This led to the confirmation of MammaPrint®, a groundbreaking test examining 70 genes to identify patients at low genomic risk who could avoid chemotherapy. Among those identified as low genomic risk, 94.7% remained disease-free after five years.

Long-term monitoring 11 of these patients at 8.7 years confirmed these findings, with 95.1% free of disease and metastasis after five years. The MINDACT trial has proven instrumental in reducing treatment where possible and paving the way to optimised care and quality of life for patients.

Study coordinator: Prof. Fatima Cardoso

11 Viale, G. et al. High concordance of protein (by IHC), gene (by FISH; HER2 only), and microarray readout (by TargetPrint) of ER, PgR, and HER2: results from the EORTC 10041/BIG 03-04 MINDACT trial. Annals of Oncology 25, 816–823 (2014).

STUDY INFORMATION
PUBLICATION

This EORTC clinical trial was part of a series that proved that treatment focussed on preserving breast instead of mastectomy (removal of the breast) could be used in certain women diagnosed with early breast cancer. It showed that patient survival was identical in those receiving the two treatment options. This is an important study, as it enabled a change in the standard of practice, improving the patients’ quality of life while equally helping doctors to better inform their patients of their options. To date, for most women diagnosed with early breast cancer, breast conservation treatment remains an option, sparing them from medically unnecessary, more extensive surgery (removal of the breast).

Study Coordinators: Prof Harry Bartelink and Prof J.A. van Dongen

12 Litière, S. et al. Breast conserving therapy versus mastectomy for stage I-II breast cancer: 20 year follow-up of the EORTC 10801 phase 3 randomised trial. Lancet Oncol 13, 412–419 (2012).

STUDY INFORMATION
PUBLICATION

In early breast cancer, doctors first assess whether the tumour has affected the lymph nodes via sentinel node biopsy to determine treatment needs. If positive, axillary dissection (removal of the lymph nodes in the armpit) is done, often causing long-term health issues and impacting patients’ quality of life.

Sparing women from lifelong health complications

The AMAROS clinical trial sought to investigate whether, in cases of a positive sentinel biopsy, radiation of the affected area could be an alternative to surgical removal, thus sparing women from permanent health complications following the surgical removal of the lymph nodes. The EORTC clinical trial found radiation to be an effective alternative to surgical removal in regional control of the tumour.

Study coordinator: Prof. Emiel Rutgers

STUDY INFORMATION
PUBLICATION

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